Officials at Covered California recently reported that though a sufficient amount of African Americans are aware of the program, only a very few are benefitting from it. That is why, they said, they are ramping up their efforts to get the word out, via social and traditional media. The health insurance exchange launched its third open enrollment November 1.

“We know we’ve come up short in who’s enrolled today,” Covered California Executive Director Peter Lee said at a recent media briefing on the exchange’s marketing and outreach plans. “Of those who are still uninsured, we want to make sure we reach them.”

In California, about 2.2 million Californians remain uninsured but are eligible for Medi-Cal or Covered California insurance plans, Lee said. They are more likely to be Latino and African American, and younger and slightly more affluent than current enrollees, who may have qualified for subsidies or Medi-Cal, the state’s version of Medicaid. Covered California’s open enrollment runs from Nov. 1 to Jan. 31, 2016.

Covered California has earmarked about $50 million for marketing and another $13 million for navigators, trained counselors who help people learn about and sign up for coverage, officials said. But despite the ample funding and more aggressive marketing, officials said that attitudes among potential participants are the real obstacle when it comes to enrollment.

“We’ve got people who don’t trust the government,” said Dan Daniels, coastal area director of the NAACP California State Conference, who oversaw Affordable Care Act outreach in his region.

Daniels also cited attitudes among “young invincibles,” who are healthy enough to think they don’t need coverage and are willing to pay the mandatory penalty for not having health insurance. That penalty will rise in 2016 to $695 per person or 2.5 percent of income, whichever is higher.

But most importantly, said CC officials, concerns about the cost of insurance options seemed to worry some Californians the most. Some make too much to be eligible for subsidized coverage and yet, costs for what they could get with the program, seem exorbitant compared with their incomes. Kemisha Roston from Riverside is a good example.

Roston is a contract lawyer, living in Riverside who still has a student loan to pay off in addition to other life expenses. Paying up to $300 a month for coverage is a hard option.

“I’m living check to check, because the market for attorneys is very saturated,” Roston said. “My health is pretty good right now, so I don’t need to go to the doctor. When I do, I go to free clinics or Planned Parenthood. I’m dismayed, because if something does happen and I don’t have health insurance, I could be wiped out.”

Said Hector De La Torre, executive director of the Transamerica Center for Health Studies, “you have these challenges in these communities and it takes a lot more than a TV commercial to make them aware of what they need to do – you can’t do that in 30 seconds.”

Lee has told reporters recently that Covered California is stepping up its ground game and changing its messaging. Consumer surveys have shown that potential enrollees need more education on how subsidies can lower their out-of-pocket costs, he said. The U.S. Department of Health and Human Services said it will pursue a similar strategy of publicizing financial help available to many people.